I am working on my first COMBO. I want it to be strong but to spare a PI for future use or when it becomes available in one a day dosing. I was thinking of D4T+DDI+HU+SUSTIVA. iT WOULD BE EASY TO TAKE, DDI first thing in the morning, D4T+HU with breakfast and dinner, Sustiva upon retiring to bed. What do you think?? The other alternative is COMBIVIR and Sustiva but I think it is weaker!!

Well, you propose a combination that makes sense... whether it is stronger than combivir/sustiva is of course unknown. But we in Boston have just started to participate in a study - going on in several cities around the world - to test exactly the combination you describe - we are comparing it a combination of just the d4T/ddI/Sustiva. We are using a new formulation of ddI - in 200 mg. tablets - which makes taking it just a bit easier - and we are doing the ddI once a day as you mention. By the way you can take ddI the same time as Sustiva - as long as the ddI is two hours after food it is OK. (And sustiva is not considered food...) If you live in a location where the study is going on - you can consider joining the study since doing the combination is of interest to you - and the only randomization is whether or not people also get hydroxyurea initially. (It could be added if needed later on as an intensification step as well...).

We don't yet know if the hydrea is needed in the combination of these three meds - they are expected to be pretty potent even without the hydroxyurea - but this study should help figure this out.

By the way, this combination is being tested not only for those who are taking their first combination, but who have taken another combination of antivirals and had viral rebound on it - it might work as a first - or second combination after, say, AZt/3TC with or without a PI.

So - while we don't have the results of our study - I would say it is likely to be a reasonable choice to make.

Good luck! CC